Apologies were received from Councillor Brian Lewis Lavender and Councillor Najeeb Latif attended as a substitute.

Apologies were received from Councillor Abdul Latif and Councillor Stephen Crowe attended as a substitute.

none

The minutes of the previous meeting were agreed as a true and accurate record.

Professor Rhodes, Acting Medical Director provided an update on the latest position with the Urogynaecology Clinic which provides services for management of women with pelvic floor dysfunction at St George’s University Hospital NHS Foundation Trust. Professor Rhodes reported that feedback from service users and patients and scrutiny panels demonstrated that there is a strong desire to maintain a service in South West London. The St George’s Trust Board considered this and decided not to permanently close the service. Wandsworth Clinical Commissioning Group (CCG) has been tasked with considering what level of service is required and where it will be held.

Panel members asked; if St George’s have the money to invest in another service,  the timetable around the provision of a new service, if the service will be provided by GP’s. Professor Rhodes said the commissioners will decide the level of service that is required and provide the associated funding for it. The timetable is unclear but they expect a proposal later this year and if any new provision is agreed upon it is probable this will begin in the new financial year.

A panel member asked if Wandsworth CCG will be taking the final decision even though Merton patients will be affected. Professor Rhodes reported that Wandsworth will be providing the majority of the funding.

A panel member asked what action has been taken to address the concerns raised by patients about the service at Croydon hospital. Professor Rhodes reported that there had been no complaints in the last five to six months. New patients also have the option to go to St Helier, or Kingston.

A panel member asked if Wandsworth CCG have involved South West London Women’s Action Group in the consultation. Professor Rhodes reported representatives from the group regularly attend St George’s Board however their  involvement with the Wandsworth CCG will need to be confirmed.   

RESOLVED

The Chair on behalf of the Panel to write to Wandsworth CCG to ask them to involve South West London Women’s Action Group in the decision making process.

Patrice Beveny, Senior Commissioning Manager, Merton Clinical Commissioning Group gave an overview of the report stating that Addaction took over the delivery of the contract in 2015. There have been some obstacles as Addaction had more patients than expected due to a miscalculation.  As a result they did not have the required level of staffing. A recovery plan was put into place and the service has improved but still need to meet targets on waiting times, recovery times and treatment.

Sue Hilyard Director of Commissioning Operations, Merton CCG  said she had inherited a challenging position in January.  They are still cautious about advertising as they want to clear the back log and improve service.

Kerry Smith Director of Addaction  said they are taking self- referrals and referrals from the community. Addaction attend community events such as the Mitcham Carnival to raise awareness of their services.

Panel members raised concerns about  possible high turnover with the use of temporary staff to support people with mental health problems, the cost of the contract, what happens if people need immediate support.  Kerry reported that Addaction now has a full complement of staff, although temporary staff did commit to the organisation for long periods of time. The panel were informed that the service is on an activity based contract. A referral is assessed to determine the level of need and then prioritised. 

RESOLVED

The Improving Access to Psychological Therapies Team agreed to attend the panel in November to provide an update on the progress with the service.

The Director of Public Health reported that the department were required to make in- year savings. The July principles helped to guide difficult decisions by protecting vulnerable children and adults and making efficiencies to protect front line services. Public Health will also work with the Health and Wellbeing Board and departments across the council to embed public health principles.

A panel member asked about the underspend which resulted in  £600,000 being transferred to adult social care. The Director of Public Health reported that overall there is uncertainty and concern for future funding. However there was some money within the budget to support adult social care and  this helped to ensure the service is fully efficient.

A panel member asked if the saving for the de-commissioning of the handy man service is a false economy as this service can prevent older people having hazards in the home that can lead to falls. There is also £40,000 surplus in the savings budget.

The Director of Public Health reported that the savings plan is more stringent than target to manage uncertainty, they have also built in a small margin of error. All the services provided by public health team focus on prevention so there could be an impact in the longer term. The team are trying to not be short termed focussed and work in silos but rather look across the system to ensure minimum impact of budget savings. There is also a mop up service for handy man service.

A panel member said Age UK provide a handy man service and had to absorb additional costs following the end of the council service and would therefore like more details about the mop up service. The Director of Public Health agreed to provide details of the alternative to the handyman service

A panel member said why the substance misuse contract is being re-procured. The Director of Public Health said the package was stringent and therefore no bids were received. There has been significant learning from the process and the team will work with providers at an earlier stage in future.

A panel member expressed concern about the significant savings in Live-Well re-procurement which will in turn lead to reductions in the smoking services. Again this prevention services is a false economy as it can prevent the onset of other more expensive health conditions and can lead increases in unemployment.

 The Director of Public Health reported that the current system does not incentivise prevention. Although the NHS will benefit from smoking cessation, the funding for the service  is provided from the public health budget. The Sustainability and Transformation Plans will seek to address this and take a holistic approach across the health system and make it easier for budgets to be pooled and organisations to work together.

A panel member queried the changes to the smoking cessation budget. The Director of Public Health reported that the service will be targeted at the most vulnerable. The Public Health team are looking at digital measures and  ...  view the full minutes text for item 6.

Task group members were thanked for their work. The Panel look forward to receiving the full report and recommendations.

RESOLVED

The summary of the work was noted by the Panel

The work Programme was agreed.

The Panel agreed that the task group would look loneliness across the age ranges in the context of promoting resilience and independence. Councillors;  Grocott, Skeete, Atwar and Kenny agreed to participate in the review.

The Chair informed the Panel that Myrtle Agutter had resigned as co-opted member. The chair led the panel in thanking Myrtle for her extensive contribution over a long period of time.

RESOLVED

The panel agreed to write to Myrtle Agutter to thank her for her contribution to health scrutiny in Merton.